{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:49:38Z","timestamp":1791607778387,"version":"4.3.4"},"reference-count":56,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100008752","name":"Deutsche Sporthochschule K\u00f6ln","doi-asserted-by":"publisher","award":["L\u201011\u201010011\u2010283\u2010093000"],"award-info":[{"award-number":["L\u201011\u201010011\u2010283\u2010093000"]}],"id":[{"id":"10.13039\/501100008752","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Med Sci Sports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Medial knee osteoarthritis (KOA) is characterized by altered joint loading that accelerates disease progression. Cycling is often recommended as a low\u2010impact exercise, yet the instantaneous and cumulative determinants of knee joint loading remain unclear. This study examined cyclists with and without KOA to characterize how power, cadence, and crank torque relate to knee load during cycling. Fifty\u2010six recreational cyclists (19 KOA, 19 age\u2010matched controls (CO), 18 younger controls (CY)) performed 3 cadences (60\/80\/100\u2009rpm) at 3 power outputs (157\/210\/261W). Three\u2010dimensional kinematics and pedal reaction forces were used to compute knee moments via inverse dynamics. Instantaneous loading was quantified as peak knee adduction (KAM\n                    <jats:sub>peak<\/jats:sub>\n                    ), flexion (KFM\n                    <jats:sub>peak<\/jats:sub>\n                    ), and extension (KEM\n                    <jats:sub>peak<\/jats:sub>\n                    ) moments. Cumulative exposure was assessed using fatigue\u2010weighted cumulative knee load (wCKL\n                    <jats:sub>KAM<\/jats:sub>\n                    , wCKL\n                    <jats:sub>KFM<\/jats:sub>\n                    , wCKL\n                    <jats:sub>KEM<\/jats:sub>\n                    ) normalized to 1\u2009h of cycling. Mixed\u2010effects linear models tested the effects of crank torque, power, and cadence on instantaneous and cumulative load. Crank torque best explained all instantaneous moments (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). KOA showed larger positive sensitivity to crank torque in KAM\n                    <jats:sub>peak<\/jats:sub>\n                    than both control groups, but smaller torque\u2010related increases in KFM\n                    <jats:sub>peak<\/jats:sub>\n                    (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009\u2264\u20090.01). For cumulative loading, power best explained wCKL\n                    <jats:sub>KAM<\/jats:sub>\n                    and wCKL\n                    <jats:sub>KFM<\/jats:sub>\n                    , where opposing effects of instantaneous load and cycle count cancel the net effect of cadence. However, higher cadence at a given power was associated with greater wCKL\n                    <jats:sub>KEM<\/jats:sub>\n                    , particularly in KOA (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). These results show that crank torque drives instantaneous knee loading, while power output and cadence govern cumulative exposure, highlighting the added value of cumulative metrics for characterizing differences in knee joint loading patterns between cyclists with and without KOA.\n                  <\/jats:p>","DOI":"10.1111\/sms.70259","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T12:17:03Z","timestamp":1773663423000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Instantaneous and Cumulative Knee Joint Loading in Cycling With and Without Medial Knee Osteoarthritis"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2991-2698","authenticated-orcid":false,"given":"Jonas","family":"Ebbecke","sequence":"first","affiliation":[{"name":"Institute of Biomechanics and Orthopaedics German Sport University Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0401-885X","authenticated-orcid":false,"given":"Lasse","family":"Hansen","sequence":"additional","affiliation":[{"name":"Institute of Biomechanics and Orthopaedics German Sport University Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5106-9513","authenticated-orcid":false,"given":"Josef","family":"Viellehner","sequence":"additional","affiliation":[{"name":"Institute of Biomechanics and Orthopaedics German Sport University Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3623-9764","authenticated-orcid":false,"given":"William Brent","family":"Edwards","sequence":"additional","affiliation":[{"name":"Human Performance Laboratory, Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"},{"name":"McCaig Institute for Bone and Joint Health, University of Calgary  Calgary Alberta Canada"},{"name":"Department of Biomedical Engineering University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8927-4053","authenticated-orcid":false,"given":"Nina","family":"Naeckel","sequence":"additional","affiliation":[{"name":"Institute of Biomechanics and Orthopaedics German Sport University Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-3802","authenticated-orcid":false,"given":"Wolfgang","family":"Potthast","sequence":"additional","affiliation":[{"name":"Institute of Biomechanics and Orthopaedics German Sport University Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42089"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34453"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2012.09.012"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2020.603907"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000759"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.7.617"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:ABME.0000017541.82498.37"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231172773"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.03.007"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2014.07.005"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/54.4.M184"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215520971795"},{"key":"e_1_2_11_14_1","first-page":"22","article-title":"Exercise\u2010Induced Effects on Inflammatory Markers and Brain\u2010Derived Neurotrophic Factor in Patients With Knee Osteoarthritis. 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